Inspection·October 19, 2024

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation and resident and staff interview, it was determined that the facility failed to maintain comfortable and safe temperature levels between 71 and 81 degrees Fahrenheit on two of two floors (Second and Third floors). Findings include: Observation of the facility on October 19, 2024, at 3:00 PM revealed the following temperatures: Second Floor: Resident room [ROOM NUMBER], 83 degrees Fahrenheit Resident room [ROOM NUMBER], 84 degrees Fahrenheit Resident room [ROOM NUMBER], 84 degrees Fahrenheit Resident room [ROOM NUMBER], 82 degrees Fahrenheit Resident room [ROOM NUMBER], 83 degrees Fahrenheit Resident room [ROOM NUMBER], 83 degrees Fahrenheit Resident room [ROOM NUMBER], 82 degrees Fahrenheit Second Floor Medication room [ROOM NUMBER].4 degrees Fahrenheit Third Floor: Resident room [ROOM NUMBER], 88 degrees Fahrenheit Resident room [ROOM NUMBER], 87 degrees Fahrenheit Resident room [ROOM NUMBER], 86 degrees Fahrenheit Resident room [ROOM NUMBER], 86 degrees Fahrenheit (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 3 Event ID: 395683 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 395683 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/19/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Highlands Rehabilitation and Healthcare 918 Main Street Laporte, PA 18626 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)